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Pharmacologic class: Stimulant laxative
Therapeutic class: Laxative
Pregnancy risk category B
Unclear. Thought to stimulate colonic mucosa, producing parasympathetic reflexes that enhance peristalsis and increase water and electrolyte secretion, thereby causing evacuation of colon.
Enema: 0.33 mg/ml, 10 mg/ml
Powder for rectal solution: 1.5 mg bisacodyl and 2.5 g tannic acid
Suppositories (rectal): 5 mg, 10 mg
Tablets (enteric-coated): 5 mg
Indications and dosages
➣ Constipation; bowel cleansing for childbirth, surgery, and endoscopic examination
Adults and children ages 12 and older: 5 to 15 mg P.O. or 10 mg P.R. as a single dose
Children older than age 3: 5 to 10 mg or 0.3 mg/kg P.O. as a single dose
Children ages 2 and older: 5 to 10 mg P.R. as a single dose
Children younger than age 2: 5 mg P.R. as a single dose
• Hypersensitivity to drug
• Intestinal obstruction
Use cautiously in:
• hypersensitivity to tannic acid
• severe cardiovascular disease, anal or rectal fissures
• pregnant or breastfeeding patients.
• Make sure patient swallows tablets whole without chewing.
• Don't give tablets within 1 hour of dairy products or antacids (may break down enteric coating).
• Know that drug should be used only for short periods.
CNS: dizziness, syncope
GI: nausea, vomiting, diarrhea (with high doses), abdominal pain, burning sensation in rectum (with suppositories), laxative dependence, protein-losing enteropathy
Metabolic: hypokalemia, fluid and electrolyte imbalances, tetany, alkalosis
Musculoskeletal: muscle weakness (with excessive use)
Drug-drug. Antacids: gastric irritation, dyspepsia
Drug-diagnostic tests. Calcium, magnesium, potassium: decreased levels
Phosphate, sodium: increased levels
Drug-food. Dairy products: gastric irritation
• Assess stools for frequency and consistency.
• Monitor patient for electrolyte imbalances and dehydration.
• Instruct patient to swallow (not chew) enteric-coated tablets no sooner than 1 hour before or after ingesting antacids or dairy products. Tell him not to chew tablets.
• Advise patient not to use bisacodyl or other laxatives habitually because this may lead to laxative dependence.
• Suggest other ways to prevent constipation, such as by eating more fruits, vegetables, and whole grains to increase dietary bulk and by drinking 8 to 10 glasses of water daily.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.
bisacodylA laxative used to manage constipation, especially in the elderly, as well as neurogenic bowel dysfunction.
Enteric nerve stimulation, increases fluid and salt secretion.